1. Health and Medicine
Macionis, Sociology, Chapter Twenty-one

2. Health
A state of complete physical, mental, and social well-being (World Health Organization)
Health is as much a social as a biological issue for sociologists
Illness have their roots in the organization of society

3. Society Shapes the Health of People in 5 Major Ways
Cultural patterns define health
What is considered “healthy” is what people hold to be morally good
Cultural standards of health change over time
A society’s technology affects people’s health
Social inequality relates to health

4. Leading Causes of Death: U.S.A.
1900
Influenza and pneumonia
Tuberculosis
Stomach/intestinal diseases
Heart disease
Cerebral hemorrhage
Kidney disease
Accidents
Cancer
Disease of infancy
Diphtheria
2000
Heart disease
Cancer
Stroke
Lung disease (non-cancerous)
Accidents
Diabetes
Pneumonia and influenza
Alzheimer’s disease
Kidney disease
Blood disease

5. Who Is Healthy?
Social epidemiology – how health and disease are distributed throughout a society’s population
Factors include
Age
Gender
Social class
Race

6. Age & Gender Death is now rare among young people
Accidents and AIDS are two exceptions
Across the life course, women fare better than men
Men have higher death rates for accidents, suicide and violence
Our cultural conception of masculinity pressures men
“Coronary prone behavior”

7. Class and Race
Infant mortality rates are twice as high for poor as for wealthy
The poorest in America can die from diseases that strike children in countries like the Vietnam and Lebanon
African Americans are three times more likely to be poor compared to whites
Poverty condemns people to live in crowed unsanitary conditions that breed infectious disease
Life expectance for white children born in 2000 is six years greater than for African Americans
Poverty also breeds stress and violence

8. Cigarette Smoking Most preventable hazard to health
440,000 men & women die prematurely each year as a direct result of smoking
That number exceeds the combined death toll from alcohol, cocaine, heroin, homicide, suicide, auto accidents & aids

9. Obesity Two-thirds of U.S. adults are overweight
Obesity can limit physical activity and it raises the risk of a number of serious diseases
Social causes of obesity
Cultural forces encourage fast food
Lack of physical ability
Poor diet

10. Sexually Transmitted Diseases
“Sexual revolution” of the 1960’s saw a rise in std rates; Generated a sexual counter-revolution
Gonorrhea & syphilis
Easily treated with antibiotics
Genital herpes
Treatable but incurable
AIDS – acquired immune deficiency syndrome
Caused by human immunodeficiency virus – HIV
Incurable, almost always fatal
Specific behaviors increase risk: anal sex, sharing needles and drug use

11. Global Map HIV/AIDS Infection of Adults in Global Perspective 63% of all global HIV infections are in sub-Saharan Africa. In countries such as Botswana and Swaziland, more than one-third of people between the ages of 15 and 49 are infected with HIV/AIDS. This very high infection rate reflects the prevalence of other sexually transmitted diseases and infrequent use of condoms, two factors that promote transmission of HIV. Source: Population Reference Bureau (2003, 2005); and United Nations (2004); map projection from Peters Atlas of the World (1990).

12. The Medical Establishment
The social institution focuses on combating disease and improving health
The rise of scientific medicine
AMA – American Medical Association founded in 1847
By early 1900’s state boards agreed to certify only AMA approved
M.D.s & D.O. (Osteopaths) on one level
Other healers kept tradition but occupy lesser role
Chiropractors, herbalists, midwives, etc.

13. Holistic Medicine Patients are people Responsibility, not dependency
Holistic medicine – an approach to health care that emphasizes prevention of illness and takes into account a person’s entire physical and social environment
Patients are people
Concern for the environment in which the person lives and their lifestyle
Responsibility, not dependency
Favors an active approach to health encouraging patients take health-promoting behaviors
Personal treatment
Favoring a more personal relaxed environment, such as the person’s home

14. Medicine in Socialist Societies
China
Government controls most health care operations
“Barefoot doctors” in rural areas, traditional healing arts, acupuncture, medicinal herbs and holistic concern
Russian Federation
Medical care is in transition, but it is held the all citizens have a right to basic medical care
Tax funds are used to provide care
Disparities in medical care increase among segments of the population

15. Medicine in Capitalist Societies
Sweden (1891)
Compulsory, comprehensive government medical care system offered to all “socialized medicine”
Great Britain (1948)
Duel system of public health services (national health service) for all citizens and may also purchase private services
Canada (1972)
A single-payer model for all citizens government program (insurance company)
But, like Britain , purchase private services
Japan
Physicians have private practice
Paid like much of Europe, combination of government programs (80% of costs) and private insurance

16. Medicine in the U. S. Direct fee system
The patient pays directly for services provided by doctor and hospitals
Private insurance
60% of Americans have access to medical care benefits through their work or union
8% purchase private coverage on their own
Few programs pay all medical costs
Public insurance programs
Medicare for those over 65, Medicaid for those in poverty and for veterans
27% of Americans receive medical attention via some form of government program, though many also have some private insurance
Health maintenance organizations
An organization that provides comprehensive medical care to subscribers for a fixed fee
Preventive approach to health; makes a profit if subscribers stay healthy

17. Future of Health and Medicine
Increase the improvements in U.S. Health
Individuals taking responsibility of their own health
Double standard of health between rich and poor people
Health problems are greater in low-income countries

18. “The pessimist complains about the wind, the optimist expects it to change, the realist adjusts the sails.”
– William Arthur Ward